| NPI | 1104353390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IN 01087288A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57029287) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2023-11-06 |