| NPI | 1447349618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002161) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019022824) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-01-28 |