| NPI | 1417302274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TN 66297) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT211562) |
| 207Y00000X Otolaryngology (Licence: TN 66297) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2023-02-04 |