| NPI | 1033550785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.021447) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN8561) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |