| NPI | 1417296641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NJ 25MA11821600) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD 5371) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2023-09-22 |