| NPI | 1790646206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.036626) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12014919A) |
| Enumeration Date | 2025-11-24 |
| Last Update Date | 2025-12-19 |