| NPI | 1295464220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.033694) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-23667) |
| 1223G0001X Dentist, General Practice (Licence: WI 6001012-15) | |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-08-03 |