| NPI | 1982679015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036097545) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019020141) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2019-05-27 |