| NPI | 1841866969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7227) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL D-0006879-C1) |
| Enumeration Date | 2021-05-29 |
| Last Update Date | 2023-05-04 |