| NPI | 1255480679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 21002118) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019026513) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2019-04-10 |