NPI | 1679756704 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MA 246526) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 246526) |
Enumeration Date | 2007-12-12 |
Last Update Date | 2012-07-03 |