| NPI | 1316309321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AZ 70558) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60976095) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD60976095) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-10-12 |