NPI | 1902198294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MD 14958) |
Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: MD 14958) |
Enumeration Date | 2011-05-05 |
Last Update Date | 2024-10-30 |