| NPI | 1659624153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021002754) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019024334) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2016-08-01 |