| NPI | 1699122770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A154093) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A154093) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2024-04-28 |