NPI | 1477606234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026750) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6639) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2023-05-16 |