| NPI | 1225123938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0012X (Licence: TX N3468) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: LA MD.203167) |
| 2080S0012X Pediatrics, Sleep Medicine (Licence: TX N3468) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX N3468) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2017-01-12 |