| NPI | 1518150481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019027840) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2007022193) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2011-11-21 |