NPI | 1871705442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NC 8594) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: SC 3921) |
Enumeration Date | 2007-05-04 |
Last Update Date | 2011-09-23 |