| NPI | 1720291651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019016617) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002669-15) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2025-02-12 |