| NPI | 1326527623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019031902) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN23712) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-10-06 |