| NPI | 1902216310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DE C1-0025006) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 297505-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2022-10-26 |