| NPI | 1710469432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.031862) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019031862) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2023-12-14 |