| NPI | 1417688391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019034579) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14781) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-03-20 |