| NPI | 1457750507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: HI MD-20398) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY AM186652626O) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2021-07-16 |