NPI | 1770817868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 125055900) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036.129223) |
Enumeration Date | 2009-09-23 |
Last Update Date | 2024-03-19 |