| NPI | 1316978687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: UT 313974-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 036142390) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-11-02 |