| NPI | 1285955203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 54175) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND PT13794) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2024-02-13 |