NPI | 1184605776 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 57758) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA 21461) |
Enumeration Date | 2005-11-10 |
Last Update Date | 2022-02-02 |