| NPI | 1871988915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 30284) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2021-01892) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-08-31 |