| NPI | 1922492164 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036156929) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301501772) | 
| Enumeration Date | 2015-03-25 | 
| Last Update Date | 2021-10-21 |