NPI | 1518997246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS019609-L) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS019609L) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2015-08-13 |