| NPI | 1205840329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-015974) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021-001010) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-09-11 |