| NPI | 1972672095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0411000054) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 021001703) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-04-24 |