| NPI | 1811986219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX J7858) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: TX J7858) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: TX J7858) | |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: TX J7858) | |
| 207YS0012X Otolaryngology Sleep Medicine (Licence: TX J7858) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2016-09-12 |