NPI | 1033788310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NH 04749) |
Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4963) |
122300000X Dentist (Licence: FL DN25896) | |
Enumeration Date | 2021-06-22 |
Last Update Date | 2022-12-28 |