| NPI | 1225291347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 036138497) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 058934) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NY 286755) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NY 058934) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NY 286755) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 286755) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-09-05 |