| NPI | 1194493080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011932) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019033385) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2023-09-04 |