| NPI | 1225209562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019027462) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021002370) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2015-05-08 |