| NPI | 1972959336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IL 036.161149) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.027520) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2022-09-16 |