NPI | 1700430402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 103807) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 103807) |
Enumeration Date | 2019-07-31 |
Last Update Date | 2023-07-18 |