| NPI | 1235243890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 6491-15) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021.002951) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2023-01-09 |