| NPI | 1265412290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN 16648) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN16648) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2023-09-11 |