| NPI | 1932172459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS027331L) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012261A) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2021-11-08 |