| NPI | 1497973606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 7804) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 5920) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-04-12 |