NPI | 1982762753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OK 5822) |
Additional Taxonomies | 122300000X Dentist (Licence: LA 6941) |
122300000X Dentist (Licence: TN 11828) | |
122300000X Dentist (Licence: TX 22460) | |
Enumeration Date | 2006-12-05 |
Last Update Date | 2024-05-15 |