| NPI | 1396993945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019026374) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019026374) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2021-12-03 |