| NPI | 1851682090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0056808) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND 18530) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-06-20 |