| NPI | 1588920144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KS 04-41067) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2018016643) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2024-08-23 |