NPI | 1598735268 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6167) |
Additional Taxonomies | 122300000X Dentist (Licence: AR 2857) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2023-03-07 |