NPI | 1881580165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2025021095) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.036240) |
Enumeration Date | 2025-06-14 |
Last Update Date | 2025-08-20 |