| NPI | 1477708907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY ME116592) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: FL ME116592) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2023-10-18 |