NPI | 1578769139 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN17539) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN17539) |
Enumeration Date | 2007-06-21 |
Last Update Date | 2015-06-03 |