| NPI | 1740851765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 125.079344) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 289452) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2022-05-24 |