| NPI | 1881625010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018293) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 013996) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-01-30 |