NPI | 1669908463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A191090) |
Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX T6054) |
207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: AZ 59340) | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2023-09-27 |