| NPI | 1467458083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 36650) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 36650) |
| 207Y00000X Otolaryngology (Licence: IN 01054405A) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2014-06-02 |