| 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 |