| NPI | 1720515463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IN 01095370A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 94-09146) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2025-10-14 |