NPI | 1649330077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019017176) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021001233) |
122300000X Dentist (Licence: WI 2583015) | |
122300000X Dentist (Licence: IL 019017176) | |
Enumeration Date | 2006-12-08 |
Last Update Date | 2024-10-29 |