| NPI | 1275539801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 32102) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 32102) |
| 207Y00000X Otolaryngology (Licence: IN 01054760A) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2020-03-13 |