| NPI | 1972278034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019033631) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12013680A) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2022-07-28 |