| NPI | 1225608342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OR D11954) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019033178) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2024-11-20 |