NPI | 1942303409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MO DE015523) |
Additional Taxonomies | 122300000X Dentist (Licence: MO DE015523) |
Enumeration Date | 2006-09-07 |
Last Update Date | 2014-04-29 |