NPI | 1245751114 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 6952) |
Additional Taxonomies | 122300000X Dentist (Licence: NV 6952) |
Enumeration Date | 2017-06-30 |
Last Update Date | 2022-10-18 |