| NPI | 1639170731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036086823) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IL 036086823) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IL 036086823) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2022-05-19 |