| NPI | 1801885017 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| 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 |