| NPI | 1144665647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 47383) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 47383) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2013-09-03 |