NPI | 1649340209 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19022824) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 19024641) |
Enumeration Date | 2006-11-09 |
Last Update Date | 2008-12-29 |