| NPI | 1013404284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 76573) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS 36935) |
| 207Y00000X Otolaryngology (Licence: AR E-16313) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2026-07-17 |