| 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 |