NPI | 1831579457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL OS15033) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN21664) |
Enumeration Date | 2015-06-09 |
Last Update Date | 2020-01-11 |