NPI | 1669991758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 7258) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024746) |
Enumeration Date | 2017-09-11 |
Last Update Date | 2024-08-23 |