| NPI | 1710327358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO dr0067707) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 57130) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: OH 35.136074) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO dr0067707) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2022-03-07 |