| NPI | 1295724045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 136000238) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 136.000238) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-12-14 |