| NPI | 1437291895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA 010274) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-074660) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |