| NPI | 1699451690 |
|---|---|
| Former Name | M OMAR IBNEE ISMAIL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS044845) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2024-08-23 |