| NPI | 1093078834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301114390) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125.061127) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2020-12-15 |