NPI | 1619312956 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 306655) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 82147) |
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: LA 306655) | |
Enumeration Date | 2013-04-30 |
Last Update Date | 2025-06-06 |