| NPI | 1720189897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026667) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN16907) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-01-09 |