| NPI | 1487756441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411726) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019026944) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2008-02-03 |