| NPI | 1205222858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NM MD2022-0238) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Y00000X Otolaryngology (Licence: LA 322577) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-07-12 |