NPI | 1790327336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019.032394) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12013271A) |
122300000X Dentist (Licence: WI 1002223-15) | |
Enumeration Date | 2019-10-15 |
Last Update Date | 2020-09-23 |