| NPI | 1831685346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7043) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6553) |
| 122300000X Dentist (Licence: FL DN23631) | |
| 1223G0001X Dentist, General Practice (Licence: FL DN23631) | |
| 122300000X Dentist (Licence: AL 6553) | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2025-12-17 |