| NPI | 1598833170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021000740) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019012941) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2025-09-11 |