NPI | 1427221688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MO 014675) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 014675) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2013-03-04 |