| NPI | 1891489753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL D.007275-C1) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 18009) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2024-02-16 |