| 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 |