NPI | 1467147801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: DE G1-0011594) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DE G1-0011594) |
Enumeration Date | 2023-04-11 |
Last Update Date | 2024-11-26 |