| 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 |