NPI | 1649338393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AK AK0450) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AK AK0450) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2007-07-09 |