| NPI | 1205063047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AL D.007570-C) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN122825) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2025-10-23 |