| NPI | 1477574887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME 011118) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 10175663A) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2015-09-14 |