| NPI | 1841758349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021003132) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD LL855) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2022-02-11 |