| NPI | 1497119788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA11303300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 25MA11303300) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2024-04-10 |