NPI | 1780990168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 108827) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 10238) |
Enumeration Date | 2010-08-24 |
Last Update Date | 2024-04-11 |