| NPI | 1891937132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NJ 25MA10331100) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 272346-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2022-01-25 |