| NPI | 1689801482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MA 266458) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 266458) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 240702) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2023-04-12 |