NPI | 1952163057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS044331) |
Enumeration Date | 2024-01-25 |
Last Update Date | 2024-01-25 |