| NPI | 1780701128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021002221) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 21461) |
| 122300000X Dentist (Licence: IL 19027263) | |
| 1223E0200X Dentist, Endodontics (Licence: CT 009566) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2023-12-01 |