| NPI | 1689416323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA 2087O0000X) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125083489) |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2025-05-12 |