| NPI | 1144079823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019035613) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 600170215) |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-11-20 |