| NPI | 1427070564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-23725) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 1219) |
| 122300000X Dentist (Licence: MT DEN-DEN-LIC-23725) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-10-10 |