NPI | 1811053960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 52953) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA 21427) |
Enumeration Date | 2006-12-30 |
Last Update Date | 2010-01-19 |