| NPI | 1407902190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-133545) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A112172) |
| 208600000X Surgery (Licence: CA A112172) | |
| 208600000X Surgery (Licence: MD RES-001) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-03-16 |