NPI | 1093947558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401413532) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS036994) |
1223E0200X Dentist, Endodontics (Licence: CA 58086) | |
Enumeration Date | 2009-08-18 |
Last Update Date | 2013-01-06 |