NPI | 1609910678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: FL DN16119) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN16119) |
122300000X Dentist (Licence: AK D817) | |
122300000X Dentist (Licence: NE 4698) | |
122300000X Dentist (Licence: OR D8066) | |
122300000X Dentist (Licence: WA DE00009340) | |
122300000X Dentist (Licence: CA 40052) | |
Enumeration Date | 2007-02-16 |
Last Update Date | 2016-04-05 |