| NPI | 1700888955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IN 01042208A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.068311) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2021-05-12 |