| NPI | 1013183292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6001760-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019014591) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2025-05-22 |