| NPI | 1831592195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021002605) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029740) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |