| NPI | 1174938906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401417776) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 65036) |
| 1223E0200X Dentist, Endodontics (Licence: SC DGD.10963DS) | |
| 1223E0200X Dentist, Endodontics (Licence: MD 17787) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2024-11-19 |