| NPI | 1235340449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036109618) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01071829) |
| 207Y00000X Otolaryngology (Licence: ND 10900) | |
| 207YS0012X (Licence: MI 4301085256) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2021-12-16 |