NPI | 1194954800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: OK 6238) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 24735) |
Enumeration Date | 2009-07-02 |
Last Update Date | 2010-09-08 |