| NPI | 1508854431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 14807) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01029120A) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-05-20 |