NPI | 1902939986 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019015302) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 021000998) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2007-07-08 |