| NPI | 1225114952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 19020124) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 37000270) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |