| NPI | 1174500920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: HI DT-2420) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-024596) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-10-21 |