| NPI | 1730561796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 036.161048) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 125.066536) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2022-07-25 |