| NPI | 1538242300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 21S631) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 19A13196) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2025-09-11 |