| NPI | 1558621912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 50401) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01078700A) |
| 207Y00000X Otolaryngology (Licence: TX BP10044563) | |
| Enumeration Date | 2012-05-20 |
| Last Update Date | 2022-11-15 |