NPI | 1730274978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KY 6298) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IL 019018735) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2007-07-08 |