| NPI | 1124461108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AL 38272) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2018025679) |
| 207Y00000X Otolaryngology (Licence: LA 323416) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2020-12-30 |