NPI | 1689007825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-6024) |
Additional Taxonomies | 122300000X Dentist (Licence: MT DEN-DEN-LIC-6024) |
Enumeration Date | 2013-08-12 |
Last Update Date | 2022-08-25 |