| NPI | 1609925403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: IL 036.117122) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A87354) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-12-09 |