NPI | 1902942873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL dn16479) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN16479) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2010-12-06 |