| NPI | 1003882184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: FL DN15901) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL dn15901) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2013-02-26 |