NPI | 1811301625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN24570) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA DN1856948) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2022-03-11 |