| NPI | 1437373198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011299) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN8341) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-12-11 |