NPI | 1528273703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN17030) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 17030) |
Enumeration Date | 2007-05-11 |
Last Update Date | 2019-08-22 |