NPI | 1982836813 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6445-015) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6445-15) |
Enumeration Date | 2009-08-11 |
Last Update Date | 2011-04-11 |