NPI | 1144858382 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 335938) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-01 |
Last Update Date | 2025-07-02 |