NPI | 1023279783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 7150) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 7150) |
Enumeration Date | 2008-06-24 |
Last Update Date | 2019-08-23 |