| NPI | 1124504501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IL 021003230) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33827) |
| 122300000X Dentist (Licence: IL 019033962) | |
| 1223P0700X Dentist, Prosthodontics (Licence: MA DF11527) | |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2023-03-24 |