| NPI | 1467488221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO DR0054327) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036-102957) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2015-08-25 |