NPI | 1790984755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.092366) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO DR.0054811) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2015-06-01 |