| NPI | 1235337130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A138348) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX n0961) |
| 207Y00000X Otolaryngology (Licence: IL 125050755) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-05-22 |