NPI | 1467637082 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 10967) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 6256) |
Enumeration Date | 2008-01-02 |
Last Update Date | 2022-12-07 |