NPI | 1992803084 |
---|---|
Former Name | LLOYD ELLIOTT KEMPKA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WI 2741-015) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019027709) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2011-04-20 |