| NPI | 1265520340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019025933) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021002047) |
| 207L00000X Anesthesiology (Licence: IL 137.000564) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |