| NPI | 1306134515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL IL019028785) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028785) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2024-05-06 |