NPI | 1952146144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WI 6001596-15) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6001596-15) |
Enumeration Date | 2024-06-28 |
Last Update Date | 2024-07-16 |