NPI | 1447349618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002161) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019022824) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2014-01-28 |