NPI | 1194327478 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 061453) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AL D.6812-C1) |
Enumeration Date | 2020-11-12 |
Last Update Date | 2021-01-04 |