NPI | 1568957090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 019031963) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12013041A) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-06-27 |
Last Update Date | 2019-07-10 |