| NPI | 1548398811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019-0016695) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 0190016695) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2014-10-02 |