| NPI | 1902803646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 26782) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01038764C) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2012-12-04 |