| NPI | 1932235223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3239) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-022870) |
| 1223G0001X Dentist, General Practice (Licence: IN 12011236A) | |
| 1223G0001X Dentist, General Practice (Licence: OK 6082) | |
| 1223G0001X Dentist, General Practice (Licence: IA 08598) | |
| 1223G0001X Dentist, General Practice (Licence: TX 24405) | |
| 1223G0001X Dentist, General Practice (Licence: LA 5945) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2010-11-19 |