NPI | 1568916856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019.030866) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030866) |
Enumeration Date | 2016-08-04 |
Last Update Date | 2023-07-21 |