| NPI | 1669627865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2009005777) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019027145) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12011272A) | |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2011-05-27 |