| NPI | 1144209073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA DE00009035) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 40927) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2009-07-22 |