| NPI | 1235793266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X Otolaryngology, Sleep Medicine (Licence: PA MT218569) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2024-08-23 |