NPI | 1952545063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: AL 2275) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 2275) |
Enumeration Date | 2009-04-21 |
Last Update Date | 2009-04-21 |