NPI | 1588155824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 7031) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2018017159) |
1223G0001X Dentist, General Practice (Licence: OK 7031) | |
1223G0001X Dentist, General Practice (Licence: KS 62064) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 39371) | |
Enumeration Date | 2018-05-22 |
Last Update Date | 2024-06-17 |