NPI | 1699961243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NH 04531) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 10035) |
1223D0001X Dentist, Dental Public Health (Licence: NH 04531) | |
Enumeration Date | 2007-09-18 |
Last Update Date | 2022-10-17 |