NPI | 1144465477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS026907L) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN116611) |
Enumeration Date | 2008-12-16 |
Last Update Date | 2008-12-16 |