| NPI | 1861514986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036117954) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AL 34866) |
| 208200000X Plastic Surgery (Licence: WI 52045) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2022-05-21 |