| NPI | 1578697520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 243412) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: NY 243412) |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: WI 55984) | |
| 207YS0012X Otolaryngology Sleep Medicine (Licence: NY 243412) | |
| 207YS0012X Otolaryngology Sleep Medicine (Licence: WI 55984) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: NY 243412) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: WI 55984) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: WI 55984) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: NY 243412) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: NY 243412) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: WI 55984) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: NY 243412) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: WI 55984) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: NY 243412) | |
| 207Y00000X Otolaryngology (Licence: 55984-20) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2021-12-20 |