| NPI | 1740386739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-017272) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 021-001956) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2019-06-07 |