| NPI | 1629133459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 036071246) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME150938) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2022-10-04 |