| NPI | 1316259237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IL 019.029428) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401415046) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2017-04-26 |