| NPI | 1679276307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 58.033593) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-05-19 |