| NPI | 1952960569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 106323) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019032378) |
| 122300000X Dentist (Licence: AZ 10868) | |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2023-06-22 |