NPI | 1831160225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-023083) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS109577) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2024-02-12 |