NPI | 1023284015 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN 10742) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 10742) |
Enumeration Date | 2008-04-30 |
Last Update Date | 2008-04-30 |