NPI | 1407098197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401410947) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 15251) |
Enumeration Date | 2009-03-27 |
Last Update Date | 2009-03-27 |