| NPI | 1598103970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD60839514) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01088789A) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2022-11-30 |