NPI | 1649350661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN17169) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN17169) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2017-06-20 |