| NPI | 1205907490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021.002131) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.026678) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2007-08-31 |