| NPI | 1669817532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN 19081) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 19081) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2017-01-24 |