| NPI | 1881875961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2008007439) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 40321) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TN 40321) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TN 40321) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TN 40321) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MO 2008007439) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MO 2008007439) | |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2010-06-04 |