| NPI | 1407141799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA 481439) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A140624) |
| 207Y00000X Otolaryngology (Licence: MN 62076) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT199773) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2024-01-16 |