NPI | 1932895240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: SC DGD.10722) |
Additional Taxonomies | 122300000X Dentist (Licence: WI 6001411-15) |
Enumeration Date | 2023-04-11 |
Last Update Date | 2025-08-28 |