| NPI | 1639267511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021001197) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 19016864) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 137000092) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2008-07-11 |