| NPI | 1093728925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 5809) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019025188) |
| 1223G0001X Dentist, General Practice (Licence: NV 5022T) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |