| NPI | 1831768274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019035966) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002575-15) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-06-25 |