| NPI | 1952377574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN 10944) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: PA 021865L) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2014-06-18 |