| NPI | 1265855969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-013771) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021-000747) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |