| NPI | 1225881121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN29904) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD.10742) |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2025-02-06 |