NPI | 1013331644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021003271) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN20926) |
Enumeration Date | 2014-02-18 |
Last Update Date | 2024-07-17 |