NPI | 1457834723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 031929) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN23737) |
Enumeration Date | 2018-09-12 |
Last Update Date | 2020-06-23 |