| NPI | 1265547467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 21000607) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 190-12316) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-24 |