| NPI | 1528185071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN-12247) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 0015111) |
| 122300000X Dentist (Licence: KS 6609) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-05-12 |