| NPI | 1245211200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-011169) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019011169) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2025-12-14 |