| NPI | 1164756979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019028083) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028083) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2023-12-07 |