| NPI | 1861409211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN21003) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IL 019024719) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 13615) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-08-20 |