NPI | 1841744455 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS040856) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040856) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2019-09-12 |