| NPI | 1245258318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19025070) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010455A) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-12-30 |