NPI | 1922236959 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 114190) |
Additional Taxonomies | 174400000X Specialist (Licence: CA 174400000X - Special) |
207Y00000X Otolaryngology (Licence: OR MD165381) | |
Enumeration Date | 2009-06-29 |
Last Update Date | 2015-09-08 |