NPI | 1780684399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME78248) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME78248) |
Enumeration Date | 2005-07-26 |
Last Update Date | 2019-07-16 |