NPI | 1730380502 |
---|---|
Professional Name | LARRY DALE BROCK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AL 5347) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AL 5347) |
Enumeration Date | 2007-05-30 |
Last Update Date | 2008-11-21 |