| NPI | 1043875099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036175649) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A177121) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2025-07-24 |