| NPI | 1346297082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN17437) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: GA DN012097) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-06-19 |