NPI | 1619902582 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PR 8708) |
Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PR 8708) |
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PR 8708) | |
Enumeration Date | 2006-07-11 |
Last Update Date | 2024-05-29 |