NPI | 1033782727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2951001006) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 12326483-9922) |
Enumeration Date | 2021-07-20 |
Last Update Date | 2025-08-26 |