NPI | 1790947265 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DE G1-0001332) |
Additional Taxonomies | 122300000X Dentist (Licence: DE G1-0001332) |
Enumeration Date | 2008-06-26 |
Last Update Date | 2017-03-16 |