| NPI | 1518028059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019014164) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021014164) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-07-08 |