| NPI | 1497370209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00205182) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO D00205182) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-07-07 |