| NPI | 1912421843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OK 91) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019031275) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2023-10-26 |