| NPI | 1144533266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 871) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 8224117-9923) |
| Enumeration Date | 2010-07-18 |
| Last Update Date | 2012-02-22 |