| NPI | 1942649819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036148741) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: IL 036.148741) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2021-07-20 |