NPI | 1518114438 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 023589) |
Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: NY 023589) |
Enumeration Date | 2008-08-21 |
Last Update Date | 2016-02-23 |