| NPI | 1497136097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: AZ 69456) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO DR.0064006) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2023-08-15 |