| NPI | 1366547531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IN 01040998A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35064650) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2021-10-05 |