NPI | 1134260326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4825) |
Additional Taxonomies | 122300000X Dentist (Licence: NC 4825) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2025-09-11 |