| NPI | 1952485096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019-017383) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 019017383) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-12-09 |