| NPI | 1700912524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N6053) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01063112A) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2012-10-06 |