| NPI | 1003230665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KS 7223) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MO 2014002115) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2026-09-29 |