NPI | 1659521631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 56528) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: TX 0025229) |
Enumeration Date | 2008-09-25 |
Last Update Date | 2014-02-07 |