NPI | 1841340502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE G1-0001003) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS027082L) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2020-02-12 |