| NPI | 1386701837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019019734) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 021001407) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |