| NPI | 1437311230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401412946) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 25916) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2011-03-01 |