NPI age
17 years
Enumerated 2008-07-21
Across 56 active otolaryngology providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | M-17665 | |
| 05 (AZ) | 467998 | |
| 01 (AZ) | 57030 | AZ DEPARTMENT OF HEALTH SERVICES |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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