NPI | 1013988971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 032896) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 028814) |
1223G0001X Dentist, General Practice (Licence: CA 053606) | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 016290) | |
Enumeration Date | 2006-01-30 |
Last Update Date | 2007-07-08 |