| NPI | 1447375480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A122402) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA 60211098) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-06-04 |