NPI | 1588493530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: DE G9-0010553) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS045403) |
Enumeration Date | 2024-07-29 |
Last Update Date | 2025-09-24 |