| NPI | 1144550815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019022428) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.022428) |
| Enumeration Date | 2010-01-01 |
| Last Update Date | 2023-02-01 |