| NPI | 1215051529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 7163-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019020561) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2024-04-19 |