| NPI | 1598047003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WI 600005015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019028840) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2025-03-05 |