| NPI | 1891938296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021002736) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019026421) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2011013340) | |
| 122300000X Dentist (Licence: FL DTP602) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DTP602) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MO 2011022969) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: IL 036140395) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2021-12-02 |