| NPI | 1740818848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.032902) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12013641A) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-01-21 |