NPI | 1255496972 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA DE8575) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: ID N-04265) |
Enumeration Date | 2006-12-22 |
Last Update Date | 2016-09-19 |