NPI | 1982446449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2024049284) |
Additional Taxonomies | 122300000X Dentist (Licence: AR 4751) |
Enumeration Date | 2024-06-06 |
Last Update Date | 2025-01-29 |