| NPI | 1114365780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019030046) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 018001868) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2016-05-26 |