| NPI | 1831580620 |
|---|---|
| Former Name | BRYAN A LARA MUNOZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: LA p-183) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-02-15 |
| Last Update Date | 2019-10-22 |