NPI | 1215391255 |
---|---|
Other Name | DIMITRI BASILAKOS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: WI 1001997-15) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 9807) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-06 |
Last Update Date | 2022-08-18 |