NPI | 1023354388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019.029011) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019029011) |
Enumeration Date | 2012-12-13 |
Last Update Date | 2023-07-28 |