NPI | 1417443276 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CO 00206279) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DRPM2601) |
122300000X Dentist (Licence: NM DD4933) | |
Enumeration Date | 2018-07-05 |
Last Update Date | 2025-09-09 |