| NPI | 1518223981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: CA A155301) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD460908) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: PA MD460908) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2019-01-29 |