| NPI | 1407167489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: SC 86683) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MI 4301108235) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2022-12-14 |