Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 55180 | CA |
NPI | 1003063918 |
---|---|
Provider Name | Dr. Ephraim W Aklilu |
First Address | San Francisco, CA 94127-2187 |
Second Address | San Francisco, CA 94127-1304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2008 |
Last Update Date | 24/01/2012 |