NPI | 1093493702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN28841) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02981901) |
122300000X Dentist (Licence: NJ 22DI02981900) | |
Enumeration Date | 2023-07-11 |
Last Update Date | 2024-07-22 |