Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN18596 | FL |
NPI | 1134354491 |
---|---|
Provider Name | Dr. Anas Selman |
First Address | Hollywood, FL 33019-2926 |
Second Address | Hollywood, FL 33019-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2009 |
Last Update Date | 15/05/2009 |