| NPI | 1063610301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01073077A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 61362-20) |
| Enumeration Date | 2007-07-09 |
| Last Update Date | 2014-07-16 |