| NPI | 1821614165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: OH 30.27435) |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: IL 019034056) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2024-06-11 |