| NPI | 1467076463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 7308) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OK T-7308) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2024-05-21 |