| NPI | 1093843039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-024799) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 45526) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2015-11-11 |