| NPI | 1932133451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-102115) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL H26809) |
| 208200000X Plastic Surgery (Licence: IL 04926463) | |
| 208200000X Plastic Surgery (Licence: IL 599090) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-01-07 |