NPI | 1518198019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MO 2009013186) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2009013186) |
Enumeration Date | 2009-07-31 |
Last Update Date | 2023-12-18 |