| NPI | 1326725599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 12471) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 018002236) |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2024-07-23 |