| NPI | 1487667267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 261168690) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036115698) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036115698) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2019-08-16 |