| NPI | 1912438086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101278013) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Y00000X Otolaryngology (Licence: MO 2022009912) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-10-18 |