| NPI | 1528274321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022271) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010801A) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2021-07-06 |