NPI | 1184753915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019360) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901018542) |
Enumeration Date | 2007-03-05 |
Last Update Date | 2007-07-08 |