| NPI | 1215009923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021-002108) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 19-025805) |
| 122300000X Dentist (Licence: NC 7391) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2014-03-12 |