NPI | 1528638384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NH 04711) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VT 016.0134023) |
Enumeration Date | 2021-06-24 |
Last Update Date | 2024-06-04 |