NPI | 1942423280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN13975) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 043398) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2024-09-06 |