| NPI | 1295965028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021002611) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-028020) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2015-09-03 |