| NPI | 1750432001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019.026693) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.026693) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021.002309) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2010-06-16 |