NPI | 1396895702 |
---|---|
Other Name | VENSSA KNIGHT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 380199) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: UT 363730) |
332B00000X Durable Medical Equipment & Medical Supplies (Licence: UT 380199) | |
Enumeration Date | 2007-01-11 |
Last Update Date | 2019-07-30 |