| NPI | 1275699845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL DN13037) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: GA DN13037) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2026-08-14 |