| NPI | 1427372671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 10978) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401006438) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2024-12-30 |