NPI | 1316332554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: DC DEN1001930) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MD 16698) |
Enumeration Date | 2015-04-04 |
Last Update Date | 2024-10-18 |