| NPI | 1619923711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CA G78659) |
| Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: CA G78659) |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: CA G78659) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: CA G78659) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: CA G78659) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-01-25 |