| NPI | 1275988313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME MD26065) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: GA 88850) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Y00000X Otolaryngology (Licence: GA 88850) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2022-07-29 |