NPI | 1700318524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 64473) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-03-30 |
Last Update Date | 2022-06-07 |