| NPI | 1619158136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CO DR.0062228) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036.137210) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2019-08-08 |