| NPI | 1366026189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-25821) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 7463) |
| 122300000X Dentist (Licence: MT DEN-DEN-LIC-25821) | |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2023-06-20 |