NPI | 1750545083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021000515) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019012142) |
Enumeration Date | 2008-07-16 |
Last Update Date | 2008-07-16 |