| NPI | 1013995745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH 30.02617) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 19026248) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2025-08-21 |