NPI | 1821354770 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61471158) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35134339) |
207Y00000X Otolaryngology (Licence: CA A146999) | |
Enumeration Date | 2012-04-04 |
Last Update Date | 2024-03-19 |