| NPI | 1497953756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.002536) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019027579) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2025-05-06 |