| NPI | 1336345974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.027304) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019027304) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2023-07-27 |