| NPI | 1891902359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036113232) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD438739) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME98020) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WI 55737) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2016-03-24 |