| NPI | 1891743910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A84567) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MS 19132) |
| 207Y00000X Otolaryngology (Licence: IL 036.144906) | |
| 208D00000X General Practice (Licence: LA MD.200605) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2019-04-01 |