| NPI | 1245286095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2024004291) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: AR 3380) |
| 1223D0001X Dentist, Dental Public Health (Licence: MT DEN-DEN-LIC- 11602) | |
| 1223G0001X Dentist, General Practice (Licence: PA DS022410L) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2025-02-03 |