NPI | 1861605370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4727) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 4605) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2018-03-17 |