| NPI | 1669746418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 036-147405) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019.031724) |
| Enumeration Date | 2012-02-25 |
| Last Update Date | 2022-01-04 |