| NPI | 1689965790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX r6278) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 036.144473) |
| 207Y00000X Otolaryngology (Licence: NE 27072) | |
| 207YS0012X (Licence: NE 27072) | |
| Enumeration Date | 2011-04-23 |
| Last Update Date | 2020-12-23 |