| NPI | 1710243704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.135141) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01078432A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2020-12-31 |