| NPI | 1255329470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IL 036-111652) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI 5745520) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2016-05-06 |