NPI | 1235243189 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL dn15585) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN5838) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2022-07-21 |