| NPI | 1174888473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ID D-4445-EN) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: WA DE60425309) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2015-10-16 |