| NPI | 1407947849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN15801) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: PR 2460) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2009-03-02 |