NPI | 1770159378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN123093) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019033106) |
Enumeration Date | 2021-06-03 |
Last Update Date | 2025-03-04 |