| NPI | 1184817405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WI 6058-015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6058-015) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2023-04-05 |