| NPI | 1639502560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 326857) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 63375) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IL 036.167823) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2024-02-03 |