| NPI | 1295706265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 6934) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: KY 6934) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-12-13 |