| NPI | 1316023989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019021026) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001830) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 060009023) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |