NPI | 1861400855 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DE GI0001080) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS029074L) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DE G10001080) | |
Enumeration Date | 2006-08-04 |
Last Update Date | 2024-12-10 |