| NPI | 1417103557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: GA 072477) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125055289) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2018-09-05 |