| NPI | 1669887303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 82832) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY FK5377343) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2019-10-14 |