| NPI | 1285070938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO 00201863) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 60416) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO DEN.00201863) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2017-11-07 |