NPI | 1831547181 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D009460) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ D009460) |
Enumeration Date | 2016-05-27 |
Last Update Date | 2019-07-22 |