| NPI | 1952032484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: FL DTP880) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IL 018.002297) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OH RES.004481) | |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2026-07-07 |