| NPI | 1427534445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS109701) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN122235) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2023-12-08 |