NPI | 1649407487 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 206975) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-8725) |
Enumeration Date | 2009-06-19 |
Last Update Date | 2020-12-11 |