NPI | 1154381242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OK 76) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 5783) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2025-04-22 |