| NPI | 1679546949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2008030672) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL 036.126436) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2011-01-21 |