| NPI | 1003824863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 50 057131) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA 12132) |
| 1223E0200X Dentist, Endodontics (Licence: FL DN 12643) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2014-02-24 |