| NPI | 1386838068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: SC 56) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 136000126) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2023-08-09 |