| NPI | 1972985869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.033958) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1001157 - 15) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2026-05-20 |