| NPI | 1033267380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: HI DT-2248) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55325) |
| 1223G0001X Dentist, General Practice (Licence: WA DE00010257) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2011-02-08 |