NPI | 1902476161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX 48319) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 325230) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-06-30 |
Last Update Date | 2024-10-31 |