| NPI | 1255417010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.022809) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019022809) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2013-04-24 |