NPI | 1386701837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019019734) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 021001407) |
Enumeration Date | 2007-01-03 |
Last Update Date | 2007-07-08 |