| NPI | 1386079689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: IL 019.029615) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: MI 2901020269) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |