NPI | 1952643363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20254) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413906) |
122300000X Dentist (Licence: FL DN20254) | |
Enumeration Date | 2013-03-24 |
Last Update Date | 2020-12-15 |