| NPI | 1992370480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019034296) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 019034296) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-12-16 |