| NPI | 1689081887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 04475) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9530) |
| 1223G0001X Dentist, General Practice (Licence: KY 9530) | |
| Enumeration Date | 2014-07-20 |
| Last Update Date | 2019-05-15 |