NPI | 1538902630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: LA P-209) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: LA P-209) |
Enumeration Date | 2024-06-17 |
Last Update Date | 2024-06-17 |