| NPI | 1144352170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019021592) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-021592) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-12-10 |