NPI | 1871756130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019109418) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MO 014578) |
Enumeration Date | 2008-07-08 |
Last Update Date | 2023-01-26 |