| NPI | 1962593855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 019022370) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021001953) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-09-26 |