| NPI | 1336523943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019030277) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: VA 0401418263) |
| 1223E0200X Dentist, Endodontics (Licence: DC DEN2000256) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2023-05-12 |