| NPI | 1932488210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: NV 6171) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: AZ D009435) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2024-05-06 |