NPI | 1346297231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: LA P129) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 136000100) |
Enumeration Date | 2006-05-27 |
Last Update Date | 2012-04-12 |