| NPI | 1497488365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN10000472) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019033864) |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2024-09-24 |