NPI | 1891782603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MN D11763) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NE 6870) |
Enumeration Date | 2005-10-06 |
Last Update Date | 2021-04-27 |