| NPI | 1447248877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021-01990) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 19-025485) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2026-08-19 |