NPI | 1164560538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021001874) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019018331) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2007-12-05 |