NPI | 1427163732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 19A13581) |
Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: IL 215818) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2007-07-08 |