NPI | 1447822366 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC DGD.10975GD) |
Additional Taxonomies | 122300000X Dentist (Licence: FL 25899) |
1223G0001X Dentist, General Practice (Licence: IN 12014286A) | |
Enumeration Date | 2021-07-12 |
Last Update Date | 2025-04-22 |