| NPI | 1699108399 |
|---|---|
| Former Name | BORAM CHARLES HAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 102083) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039728) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2020-02-12 |