| NPI | 1881625754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL il036 060839) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IL il036 060839) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |