| NPI | 1477622801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: IL 019016766) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036075892) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2021-05-13 |