| NPI | 1952895252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 01931749) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2018019635) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2023-06-24 |