| NPI | 1275429771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 8121) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 14228040-8903) |
| 122300000X Dentist (Licence: UT 14228040-9926) | |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-07-10 |