| NPI | 1558981688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: HI MD-25250) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125.076044) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2025-05-28 |