NPI | 1245551951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 60787) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 60787) |
Enumeration Date | 2010-06-16 |
Last Update Date | 2016-02-06 |