| NPI | 1841517604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0061123) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101251785) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2021-08-23 |