| NPI | 1770918971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: IL 019.022065) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: FL DN12517) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2013-09-06 |