| NPI | 1184937971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 29127) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: UT 9396614-9921) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2023-01-04 |