| NPI | 1467637082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 10967) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 6256) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2022-12-07 |