| NPI | 1568529998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: OR D7D0714779) |
| Additional Taxonomies | 122400000X Denturist (Licence: WA DN00000218) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |