| NPI | 1770261885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NY 326470) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125082453) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-11-17 |