| NPI | 1588293070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 76246-20) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2021-12-03 |