| NPI | 1437100856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 036.119907) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019.027559) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-09-17 |