| NPI | 1700080678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2013-00940) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A 119313) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 141580) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: IL 036143914) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NC 2013-00940) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2019-06-20 |