NPI | 1104867431 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019.028191) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 036.125106) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2014-02-07 |