NPI | 1295715522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 22176) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22176) |
1223P0700X Dentist, Prosthodontics (Licence: TX 22176) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 22176) | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 22176) | |
Enumeration Date | 2006-01-20 |
Last Update Date | 2024-12-03 |