| NPI | 1013913342 |
|---|---|
| Other Name | RANDOLPH CHANG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-025589) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 48587) |
| 1223G0001X Dentist, General Practice (Licence: TN DS7874) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2023-03-07 |