| NPI | 1093978355 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 46261)  | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01072297A)  | 
| Enumeration Date | 2008-07-08 | 
| Last Update Date | 2017-11-16 |