NPI | 1467940312 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 4278) |
Enumeration Date | 2018-04-26 |
Last Update Date | 2018-06-07 |