| NPI | 1811305568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IL 336.009854) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01019128A) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2014-07-25 |