| NPI | 1235685801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.034073) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001317-15) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-08-28 |