NPI | 1326185612 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD60273505) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-2144) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2021-04-29 |