| NPI | 1326337544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A148235) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME126638) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2018-03-17 |