| NPI | 1124284864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 61939) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA 22287) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2024-08-23 |