NPI | 1609221563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SD 12813) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 33769) |
Enumeration Date | 2016-04-28 |
Last Update Date | 2021-08-25 |