NPI | 1982213567 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN24861) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN24861) |
Enumeration Date | 2020-07-29 |
Last Update Date | 2023-03-10 |