NPI | 1366823320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 04332) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856915) |
Enumeration Date | 2015-06-16 |
Last Update Date | 2024-04-30 |