| NPI | 1265539225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 35962) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 021-001697) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-09-06 |