| NPI | 1083675011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0012X (Licence: IN 01068512A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01068512B) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-04-05 |