| NPI | 1235393273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 59294) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL Resident Permit #677) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2010-12-16 |