NPI | 1306247812 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PR 22921) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 69904) |
207YX0901X Otolaryngology, Otology & Neurotology (Licence: PR 22921) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 4927717) | |
Enumeration Date | 2014-09-16 |
Last Update Date | 2022-10-20 |