| NPI | 1962499988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL OS10324) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: IL 036-062413) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: IN 02003616A) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2023-11-13 |