| NPI | 1790763860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019025869) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 021002266) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2008-07-26 |