| NPI | 1881732204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021.001114) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: WI 6002256-15) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2026-07-29 |