NPI | 1376717322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CO 9651) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS030834L) |
Enumeration Date | 2008-04-21 |
Last Update Date | 2014-07-31 |