| NPI | 1740260637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036111771) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL OS 11955) |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL OS 11955) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2014-01-28 |