| NPI | 1386954477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: IL 021.002516) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028334) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2022-09-30 |