NPI | 1639668668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 126800000X Dental Assistant (Licence: CA RDA85936) |
Additional Taxonomies | 126800000X Dental Assistant (Licence: CA OA49112) |
Enumeration Date | 2018-05-04 |
Last Update Date | 2018-05-04 |