| NPI | 1902885916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021.002308) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027729) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2010-07-26 |