| NPI | 1083684526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN27821) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: AL D0006732C) |
| 1223E0200X Dentist, Endodontics (Licence: TN 6862) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-08-17 |