NPI | 1104142900 |
---|---|
Former Name | DAVID JACOB RICHMAN-RAPHAEL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9732) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE 60257230) |
Enumeration Date | 2010-04-19 |
Last Update Date | 2016-10-19 |