NPI | 1962880419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D91294) |
Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MD D91294) |
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IL 036151689) | |
Enumeration Date | 2015-05-15 |
Last Update Date | 2021-06-07 |