| NPI | 1891908398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA DDS103505) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA SP237) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-02-10 |