| NPI | 1346000791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 125.084884) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.084884) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-08-19 |