| NPI | 1821376435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MO 2011016837) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 036.140675) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: KS 2015016359) | |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2018-03-17 |