| NPI | 1487694097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IL 190192603) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019012603) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021000537) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |