| NPI | 1497274252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 4193-21) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021002969) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2024-04-02 |