| NPI | 1477242212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL D.007197-C1) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 28090) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-06-23 |