NPI | 1720405004 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NV 19869) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A157725) |
207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A157725) | |
Enumeration Date | 2014-03-25 |
Last Update Date | 2020-11-30 |