| NPI | 1174880496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA A126898) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO DR0058490) |
| 207Y00000X Otolaryngology (Licence: CA A126898) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CO DR0058490) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2020-05-26 |