| NPI | 1265504617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021002028) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-024426) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2025-01-20 |