| NPI | 1972521086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IN 01066901A) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 235640) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IL 036120006) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-06-08 |