| NPI | 1720369606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001691) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019028847) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2022-07-21 |