| NPI | 1043375884 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036101706) | 
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DC MD044788) | 
| Enumeration Date | 2006-12-22 | 
| Last Update Date | 2017-03-21 |