| NPI | 1487813473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.003238) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.033956) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019.033956) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2024-05-21 |