| NPI | 1093172744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019032456) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 018001918) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 10975) | |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2020-07-31 |