| NPI | 1952539439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019021183) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 014961) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-06-23 |