NPI | 1326375247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NJ 22DI024331300) |
Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: OH 30-022703) |
Enumeration Date | 2009-11-13 |
Last Update Date | 2010-02-19 |