NPI | 1346308541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D008196) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23024) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2015-10-16 |