NPI | 1942641238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 41773) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019029503) |
Enumeration Date | 2013-07-15 |
Last Update Date | 2025-07-11 |