| NPI | 1093372039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: OR DT-DO-10224514) |
| Additional Taxonomies | 122400000X Denturist (Licence: WA DN60778096) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2022-08-04 |