| NPI | 1356818041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019033454) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1859241) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2023-01-10 |