NPI | 1295995140 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002299) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019026387) |
Enumeration Date | 2008-06-13 |
Last Update Date | 2011-02-11 |