| NPI | 1164318465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL D.007454-C1) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD.11141) |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2026-06-27 |