| NPI | 1861867103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A196173) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA A196173) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-12-12 |
| Last Update Date | 2024-08-16 |