NPI | 1104238120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NV S7-85) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 62314) |
Enumeration Date | 2014-05-25 |
Last Update Date | 2021-11-21 |