NPI | 1588235709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE70016665) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DENT.DE.70016665) |
171R00000X Interpreter (Licence: WA MA4305) | |
Enumeration Date | 2021-07-08 |
Last Update Date | 2025-10-07 |