| NPI | 1336118017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME112703) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01058318A) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01058318A) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2022-01-24 |