NPI | 1508215138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H5977) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 25644) |
Enumeration Date | 2016-06-04 |
Last Update Date | 2016-06-04 |