| NPI | 1760619019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 36128420) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 36128420) |
| Enumeration Date | 2009-06-14 |
| Last Update Date | 2019-06-12 |