| NPI | 1306929401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019018246) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN IN12009211) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2025-10-28 |