| NPI | 1326249715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101251059) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 036139764) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 140955) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2018-03-17 |