NPI | 1619406451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NC 13351) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401415638) |
Enumeration Date | 2017-06-06 |
Last Update Date | 2023-08-03 |