| NPI | 1245795525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: WA DN60869847) |
| Additional Taxonomies | 122400000X Denturist (Licence: OR DT-DO-10243833) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2024-11-12 |