NPI | 1902150352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NV S7-143) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 62986) |
Enumeration Date | 2012-11-07 |
Last Update Date | 2024-05-11 |