| NPI | 1568622355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A95116) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A95116) |
| 208200000X Plastic Surgery (Licence: IL 036.125607) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2016-03-22 |