NPI | 1508010026 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401412083) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412083) |
Enumeration Date | 2008-11-11 |
Last Update Date | 2012-07-04 |