NPI | 1760035422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NC 12694) |
Additional Taxonomies | 122300000X Dentist (Licence: ID D-5064) |
Enumeration Date | 2019-07-22 |
Last Update Date | 2022-07-18 |