NPI | 1053716324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NC 7890) |
Additional Taxonomies | 247000000X Technician, Health Information |
Enumeration Date | 2014-10-29 |
Last Update Date | 2014-10-29 |