NPI | 1609172329 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NC 8708) |
Additional Taxonomies | 122300000X Dentist (Licence: NC 8708) |
Enumeration Date | 2011-01-27 |
Last Update Date | 2023-06-15 |