NPI | 1184881328 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NY 034619) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NY 034619) |
Enumeration Date | 2008-05-16 |
Last Update Date | 2008-05-16 |