NPI | 1447742358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-5554) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY S15-692-135) |
Enumeration Date | 2018-06-06 |
Last Update Date | 2023-08-08 |