NPI | 1033697107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401416239) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN23713) |
Enumeration Date | 2018-08-01 |
Last Update Date | 2018-08-01 |