NPI | 1437746088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61089052) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE61089052) |
Enumeration Date | 2020-12-30 |
Last Update Date | 2020-12-30 |