| NPI | 1003283458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401418660) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: OH 30.027789) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2024-12-18 |