| NPI | 1932748977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021.003327) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.035017) |
| 122300000X Dentist (Licence: FL DN24642) | |
| 1223E0200X Dentist, Endodontics (Licence: FL DN24642) | |
| Enumeration Date | 2019-12-21 |
| Last Update Date | 2024-09-09 |