| NPI | 1184942310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 081972) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WV 25349) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2022-04-12 |