| NPI | 1265809388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019030413) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021002758) |
| 1223P0300X Dentist, Periodontics (Licence: TX 34738) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2021-09-02 |