NPI | 1003332784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8996) |
Additional Taxonomies | 122300000X Dentist (Licence: SC 8996) |
Enumeration Date | 2017-08-15 |
Last Update Date | 2018-07-20 |