| NPI | 1801010046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: WA DN 60153167) |
| Additional Taxonomies | 122400000X Denturist (Licence: OR DT-DO-10111220) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2012-04-19 |