| NPI | 1588416440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.003556) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.035565) |
| 122300000X Dentist (Licence: IN 12015083A) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12015083A) | |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2026-09-04 |