NPI | 1265623417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS027711L) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: PA DS027711L) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2022-04-20 |