| NPI | 1750407334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: CA A121464) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301083303) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301083303) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-04-28 |