| NPI | 1871829234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 34605) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE60247129) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 6922) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401413383) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 49715) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2023-05-29 |