NPI | 1043457799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9218) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4977) |
Enumeration Date | 2009-01-17 |
Last Update Date | 2018-11-06 |