| NPI | 1861809097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OR MD209425) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD 1861809097) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD 1861809097) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2022-07-01 |