NPI | 1679521926 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: AK 1204) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: FL 7418) |
1223P0700X Dentist, Prosthodontics (Licence: AL 3544) | |
Enumeration Date | 2006-05-05 |
Last Update Date | 2007-07-08 |