| NPI | 1851852560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MA 1021889)  | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125.074394)  | 
| Enumeration Date | 2019-03-26 | 
| Last Update Date | 2025-06-24 |