| NPI | 1295123529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: WI 1001070-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030212) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: IL 137.000929) | |
| 122300000X Dentist (Licence: WI 1001070-15) | |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2017-04-10 |