| NPI | 1801058391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.139574) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD444166) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PA MD444166) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019841) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2022-07-21 |