| NPI | 1669439865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.030195) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN14742) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2025-10-07 |