NPI | 1417047614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NE 5252) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE N5252) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2023-10-04 |