NPI | 1942578869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27587) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 27587) |
Enumeration Date | 2011-12-06 |
Last Update Date | 2011-12-06 |