| NPI | 1124556923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA R-10907) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: IA R-10907) |
| 207YS0012X Otolaryngology Sleep Medicine (Licence: IA R-10907) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: IA R-10907) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: IA R-10907) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: IA R-10907) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: IA R-10907) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: IA R-10907) | |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2017-05-24 |