NPI | 1548428998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019027676) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019781) |
Enumeration Date | 2008-05-31 |
Last Update Date | 2019-06-19 |