NPI | 1932202892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019022537) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021001645) |
Enumeration Date | 2006-09-06 |
Last Update Date | 2007-07-08 |