| NPI | 1538271101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 19-025633ENDODONTIST) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA 012842) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-07-27 |