NPI | 1346974581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.033899) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019033899) |
Enumeration Date | 2022-07-13 |
Last Update Date | 2022-10-26 |