NPI | 1043426943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 29523) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AZ D7207) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2021-01-15 |