NPI | 1144292830 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: WI 6081-015) |
Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: MN D11471) |
Enumeration Date | 2006-02-06 |
Last Update Date | 2008-03-24 |