NPI | 1538663273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: VA 1010280100) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125.072627) |
Enumeration Date | 2018-03-19 |
Last Update Date | 2025-01-23 |