| NPI | 1003659525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL D.007345-C1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC DGD.10849) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-24 |