| NPI | 1821386756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 7649) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 8029303-9922) |
| 1223G0001X Dentist, General Practice (Licence: WA DE 60342662) | |
| 1223G0001X Dentist, General Practice (Licence: AZ D010444) | |
| 1223G0001X Dentist, General Practice (Licence: OK 7649) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2024-11-12 |