NPI | 1649505900 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25001) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 25001) |
Enumeration Date | 2009-10-05 |
Last Update Date | 2024-11-11 |