| NPI | 1942930821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019033768) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2022021029) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2024-07-23 |