| NPI | 1962843961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-26) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV 3742) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |