NPI | 1992843213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NE 5223) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 13778) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2012-09-05 |