| NPI | 1477787687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 286369-1) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 50873) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Y00000X Otolaryngology (Licence: PA MT195538) | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2018-02-05 |