| NPI | 1952523292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN18145) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA 9418) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2009-07-21 |