NPI | 1376717603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036-138547) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 036-138547) |
Enumeration Date | 2008-04-17 |
Last Update Date | 2020-11-04 |