| NPI | 1841586450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: IL 036.135966) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL 125060058) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2019-09-04 |