NPI | 1417158189 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: DE G1-0001140) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: PA DS029819L) |
Enumeration Date | 2007-05-30 |
Last Update Date | 2007-07-08 |