| NPI | 1174521074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-084126) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036084126) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MO MDR5N96) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-12-19 |