| NPI | 1043335276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IL 021.002815) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.030537) |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 38430-1) | |
| 1223P0700X Dentist, Prosthodontics (Licence: NC 0007) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-01-14 |