| NPI | 1396086286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 5101020558) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 297940) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2023-06-30 |