| NPI | 1942327531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 110060) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019021179) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2024-09-16 |