NPI | 1164494332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MO 13236) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: KS 6100) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2013-02-08 |