NPI | 1518530435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN28132) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IL 019.033252) |
Enumeration Date | 2021-07-19 |
Last Update Date | 2023-11-27 |