| NPI | 1073687927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019021347) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021001664) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |