NPI | 1336345974 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.027304) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019027304) |
Enumeration Date | 2007-06-21 |
Last Update Date | 2023-07-27 |