NPI | 1730477084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CO 10468) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CO 00010468) |
Enumeration Date | 2011-07-20 |
Last Update Date | 2020-12-28 |