NPI | 1720345044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 67502) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 75085) |
Enumeration Date | 2012-04-12 |
Last Update Date | 2021-07-22 |