NPI | 1992962070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401008063) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MD 9122) |
Enumeration Date | 2008-05-17 |
Last Update Date | 2008-05-17 |