| NPI | 1841448008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 6662737-9922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 6662737-9921) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2010-11-01 |