| NPI | 1548550502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2018038932) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 39232) |
| 207Y00000X Otolaryngology (Licence: KS 04-40511) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2024-08-21 |