NPI | 1790767119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX R7968) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 223913) |
Enumeration Date | 2005-11-20 |
Last Update Date | 2023-06-15 |