| NPI | 1548614290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 62646) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS T-3211) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2021-05-04 |