| NPI | 1144477902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021.002274) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.027600) |
| 1223G0001X Dentist, General Practice (Licence: MO 2005015642) | |
| 1223G0001X Dentist, General Practice (Licence: NE 6602) | |
| Enumeration Date | 2008-08-24 |
| Last Update Date | 2008-08-24 |