| NPI | 1609259084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IL 019029563) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 021002839) |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2023-07-20 |