| NPI | 1841390986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-25955) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D6265) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-11-03 |