| NPI | 1225490840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036155286) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.028395) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2021-07-09 |