| NPI | 1447494521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401413980) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: DC den1001317) |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2024-05-02 |