NPI | 1376172163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A200669) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-03 |
Last Update Date | 2025-06-01 |