| NPI | 1144043241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC LL95140) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ 018522) |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2025-08-11 |