NPI | 1306341631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME169684) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD480803) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-28 |
Last Update Date | 2024-08-22 |