| NPI | 1487824850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001763) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019022939) |
| Enumeration Date | 2008-03-02 |
| Last Update Date | 2008-03-02 |