| NPI | 1518944099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022032) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PR 003324) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-05-16 |