| NPI | 1356506364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027741) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019027741) |
| 1223G0001X Dentist, General Practice (Licence: AZ D7933) | |
| Enumeration Date | 2008-07-20 |
| Last Update Date | 2012-09-17 |