| NPI | 1699888644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-109103) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NC 2020-00458) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-06-24 |