NPI | 1467439604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: HI DT1874) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 019-022821) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2007-07-08 |