| NPI | 1194859355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021-001850) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-024407) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2008-10-02 |