NPI | 1144529942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NV 6133) |
Additional Taxonomies | 122300000X Dentist (Licence: UT 7839001-9921) |
Enumeration Date | 2011-03-18 |
Last Update Date | 2011-03-18 |