| NPI | 1871616532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025104) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 12285) |
| 1223G0001X Dentist, General Practice (Licence: IN 12010709A) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2023-08-02 |