| NPI | 1518313063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WA OP60766695) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA OP60766695) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2023-08-14 |