| NPI | 1912351289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61291537) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA FE61154516) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA FE61154516) | |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD61291537) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2023-01-05 |