| NPI | 1497984835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NV 15367) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A112136) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2021-06-09 |