NPI | 1538517867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 72497) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-05-26 |
Last Update Date | 2023-03-21 |