NPI | 1326884461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN29457) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN123462) |
Enumeration Date | 2024-07-08 |
Last Update Date | 2025-03-07 |