NPI | 1942043146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WI 6001600-15) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.035179) |
Enumeration Date | 2024-06-15 |
Last Update Date | 2024-08-14 |