| NPI | 1336090455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN124068.) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 13068) |
| Enumeration Date | 2026-02-05 |
| Last Update Date | 2026-03-17 |