| NPI | 1336870823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS044240) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.033841) |
| 122300000X Dentist (Licence: IN 12013853A) | |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2024-08-04 |