NPI | 1053448563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO 8445) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 8445) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2024-02-05 |