NPI | 1134386097 |
---|---|
Professional Name | ROBERT MONDAVI |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 42169) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 42169) |
Enumeration Date | 2008-05-19 |
Last Update Date | 2008-05-19 |