| NPI | 1144387275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019.017449) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 01917449) |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2021-12-16 |