| NPI | 1477395523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.035464) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12014482A) |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2026-07-06 |