| NPI | 1457487415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036103581) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G86115) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |