NPI | 1730243056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021001002) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 019014048) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2009-09-23 |