NPI | 1932301892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PR 16503) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME104110) |
Enumeration Date | 2007-06-04 |
Last Update Date | 2011-03-09 |