| NPI | 1366607806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MT DEN-DEN-LIC-30891) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 7577) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2025-06-29 |