| NPI | 1003234287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 021003032) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019029867) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MI 2901022524) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-05-25 |