| NPI | 1396892030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019016584) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010685) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-04-12 |