NPI | 1538393152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24223) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 24223) |
Enumeration Date | 2009-05-11 |
Last Update Date | 2024-02-20 |