| NPI | 1851020911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 10894) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DRPM2430) |
| 1223G0001X Dentist, General Practice (Licence: FL 2430) | |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2023-07-09 |