NPI | 1912391707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR H6818) |
Additional Taxonomies | 174H00000X Health Educator (Licence: OR H6818) |
Enumeration Date | 2015-03-19 |
Last Update Date | 2015-04-08 |