NPI | 1891355848 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DE G1-0011487) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042548) |
Enumeration Date | 2019-06-20 |
Last Update Date | 2023-11-21 |