| NPI | 1326127630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL D-0006586-C) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 14268) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2025-09-15 |