| NPI | 1144607532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 54383) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 1144607532) |
| 207Y00000X Otolaryngology (Licence: SC 84065) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2021-07-09 |