| NPI | 1851672182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.028841) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MT 2468) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2026-08-11 |