NPI | 1588895916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS037961) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS037961) |
Enumeration Date | 2009-08-03 |
Last Update Date | 2021-09-30 |