| NPI | 1871696922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 021001050) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019.014839) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 137000009) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: IL 137000009) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-10-25 |