| NPI | 1487210829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0102821) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 329150) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2025-06-25 |