NPI | 1538592654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019029609) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019029609) |
204E00000X Oral & Maxillofacial Surgery (Licence: IL 019-029609) | |
Enumeration Date | 2013-08-13 |
Last Update Date | 2022-05-21 |