| NPI | 1912079872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 01923674) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019023674) |
| 122300000X Dentist (Licence: IL 019023764) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2023-11-20 |