| NPI | 1124313838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.028905) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012053A) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2022-02-13 |