| NPI | 1801885017 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 40325) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01055967A) | 
| Enumeration Date | 2005-10-19 | 
| Last Update Date | 2012-11-06 |