| NPI | 1588780274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D07479) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019021609) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2025-06-25 |