| NPI | 1033185871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN-5133) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010424A) |
| 1223G0001X Dentist, General Practice (Licence: OK 5643) | |
| 1223G0001X Dentist, General Practice (Licence: NM DD2030) | |
| 1223G0001X Dentist, General Practice (Licence: KS 60184) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-09 |