| NPI | 1346987732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019036786) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401417941) |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2026-01-16 |