NPI | 1730797994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN 11862) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36316) |
Enumeration Date | 2020-07-14 |
Last Update Date | 2023-11-30 |