| NPI | 1013440890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IN 01090526A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 510031001749) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 510031001749) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-08-18 |