| NPI | 1518114859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: RI MD14569) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 125048116) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: SD 8079) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2014-05-19 |