NPI | 1821098807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OR D10778) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AK 119150) |
1223E0200X Dentist, Endodontics (Licence: SD D0906) | |
Enumeration Date | 2005-07-29 |
Last Update Date | 2018-03-29 |