NPI | 1649241092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 55266) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 22375) |
1223E0200X Dentist, Endodontics (Licence: HI DT - 2276) | |
Enumeration Date | 2006-02-01 |
Last Update Date | 2014-09-12 |