| NPI | 1679566418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: RI DEN03064) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019-026275) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2010-02-02 |