| NPI | 1003865304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 35789) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01058901A) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2011-07-21 |