NPI | 1174511844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: PR 1385) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: PR 1385) |
Enumeration Date | 2005-10-07 |
Last Update Date | 2013-06-04 |