NPI | 1750432761 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 5125) |
Additional Taxonomies | 122300000X Dentist (Licence: NV 5125) |
Enumeration Date | 2007-01-16 |
Last Update Date | 2024-09-06 |