| NPI | 1790034445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036158043) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 59126) |
| Enumeration Date | 2012-09-09 |
| Last Update Date | 2021-12-03 |